The investigators will develop a radiomics signature for immune checkpoint-induced
pneumonitis in 40 patients with a pulmonary event under anti-PD1 or anti-PD-L1 (cases) and 40
patients without a pulmonary event under anti-PD1 or anti-PD-L1 (controls).
On the basis of the case-control study of patients treated with anti-PD1 or anti-PD-L1, they
will further optimise the model using reinforcement machine learning. The model will then be
validated in 300 prospective patients.

This randomized clinical trial studies the Beating Lung Cancer in Ohio protocol in improving
survival in patients with stage IV non-small cell lung cancer. The Beating Lung Cancer in
Ohio protocol may help in evaluating immunotherapies and targeted therapies that prolong
survival, have more favorable toxicity profiles than conventional chemotherapy and impact
quality of life.

This phase II trial studies how well radical-dose image guided radiation therapy works in
treating patients with non-small cell lung cancer that has spread to other places in the body
who are undergoing immunotherapy. Radiation therapy uses high energy x-rays to kill tumor
cells and shrink tumors. Giving radical-dose image guided radiation therapy to patients with
non-small cell lung cancer may help to improve response to immunotherapy anti-cancer
treatment.

This randomized pilot clinical trial studies health care coach support in reducing acute
care use and cost in patients with cancer. Health care coach support may help cancer
patients to make decisions about their care that matches what is important to them with
symptom management.

This randomized phase II/III trial studies how well giving maintenance chemotherapy with or
without stereotactic body radiation therapy works in treating patients with stage IV
non-small cell lung cancer. Drugs used in maintenance chemotherapy, such as docetaxel,
pemetrexed disodium, and gemcitabine work in different ways to stop the growth of tumor
cells, either by killing the cells, by stopping them from dividing, or by stopping them from
spreading. Stereotactic body radiation therapy is a specialized radiation therapy that sends
x-rays directly to the tumor using smaller doses over several days and may cause less damage
to normal tissue. Giving maintenance chemotherapy and stereotactic body radiation therapy
together may work better than maintenance chemotherapy alone in treating patients with stage
IV non-small cell lung cancer.

This phase II trial is studying blood and tumor tissue from patients with advanced non-small
cell lung cancer who are treated with nivolumab to better understand how nivolumab works.
Monoclonal antibodies, such as nivolumab, may interfere with the ability of tumor cells to
grow and spread by turning on the immune system (T cells). We want to study the effects of
nivolumab on the immune system (T cells) by collecting blood samples and samples from
patients' tumors.

Aggressive therapy may improve survival in synchronous oligometastatic NSCLC and the goal of
this clinical trial is to assess the efficacy and safety of local definitive radiotherapy in
this subset of patients.

This randomized pilot clinical trial studies the side effects and best dose of naloxegol and
to see how well it works in treating patients with stage IIIB-IV non-small cell lung cancer.
Naloxegol may relieve some of the side effects of opioid pain medication and fight off future
growth in the cancer.

This phase IIa trial studies how well recombinant EphB4-HSA fusion protein and pembrolizumab
work in treating patients with non-small cell lung cancer that has spread to other places in
the body or head and neck squamous cell cancer that has come back or spread to other places
in the body. Recombinant EphB4-HSA fusion protein may stop the growth of tumor cells by
blocking some of the enzymes needed for cell growth. Monoclonal antibodies, such as
pembrolizumab, may interfere with the ability of cancer cells to grow and spread. Giving
recombinant EphB4-HSA fusion protein and pembrolizumab may work better in treating patients
with non-small cell lung or head and neck squamous cell cancer.

The purpose of this study is to find the benefits of combining nivolumab with metformin in
advanced non-small cell lung cancer with and without prior treatment with immunotherapy. We
will also be looking at the safety of the combination. Nivolumab is currently approved in
certain cancers such as melanoma, lung cancer and kidney cancer. Metformin is approved by the
US Food and Drug Administration (FDA) to treat diabetes. In this study, Metformin is being
used to treat cancer. This use is not approved by the FDA; therefore, in this study, it is
considered experimental. Experimental means the U.S. FDA has not approved the drug for use in
your type of cancer. Nivolumab is an antibody (a human protein that sticks to a part of the
tumor and/or immune cells) designed to allow the body's immune system to work against tumor
cells. It is believed that metformin has immune modifying properties, meaning it can boost
your immune system. As a result, it may help certain cancer treatments, known as
immunotherapy, to work better.

Interventional studies are often prospective and are specifically tailored to evaluate direct impacts of treatment or preventive measures on disease.

Observational studies are often retrospective and are used to assess potential causation in exposure-outcome relationships and therefore influence preventive methods.

Expanded access is a means by which manufacturers make investigational new drugs available, under certain circumstances, to treat a patient(s) with a serious disease or condition who cannot participate in a controlled clinical trial.

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.

Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.

Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.

Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.

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